Prescription drug use in pregnancy and variations according to prior psychiatric history

Abstract

Purpose: Prescription drug use during pregnancy has increased during the past decades.However, little is known about prescription drug use for high-risk pregnancies. We aimed to estimate the prevalence of redeemed prescriptions in Danish pregnant women with and without previous psychiatric history.Methods: A Danish population-based descriptive study of 981 392 pregnancies ending in live-born singletons by 586 988 women aged 15 to 55 years between 1997 and 2012, of which 113 449 (11.6%) pregnancies were by women with a psychiatric history prior to the index pregnancy. All prescription drugs redeemed during pregnancy were identified, and dispensing patterns among the women were reported by therapeutic classes of drugs, calendar year of childbirth, and trimester.Results: Overall, women with psychiatric history prior to pregnancy were more likely to fill a prescription (75.8%; 95% confidence interval [CI], 75.5-76.0%), compared with women with no psychiatric history (64.5%; 95% CI, 64.4-64.6%). The difference was observed even when psychotropic drug use was excluded and in all therapeutic classes except for antineoplastic and immunomodulating drugs. The most commonly prescribed drugs were anti-infectives. Approximately 44.7% (95% CI, 44.5-45.0%) of women with psychiatric history and 31.3% (95% CI, 31.2-31.4%) of women with no psychiatric history redeemed more than one therapeutic class of drugs.Conclusions: Women with a psychiatric history were more likely to redeem prescriptions during pregnancy across almost all drug classes, especially anti-infectives. Two thirds of all women redeemed at least one prescription drug during pregnancy and one third more than one drug class.

Impact of prenatal cannabis exposure on functional connectivity of the salience network in children

“…Here, we focused on the following subscales: internalizing, externalizing, thought disorder, attention problems, and social problems. These subscales were selected as scores were previously associated with PCE in the ABCD sample (Ingstrup et al, 2018;Paul et al, 2021). We used age-and sex-normed t-scores for analyses.…”

“…Rates of cannabis use have dramatically increased in the United States over the past several decades. This increase was accompanied by more jurisdictions moving toward decriminalization and legalization, and decreased perceptions of risk of use, particularly among young people (Cohn et al, 2017;Ingstrup et al, 2018;Paul et al, 2021). Indeed, as of November 2021, recreational cannabis use was legal in 18 states; although, it remains illegal at the federal level due to the Supremacy Clause.…”

“…To address these gaps, this study leverages ABCD data to examine the impact of PCE on within and between network resting‐state functional connectivity (rsFC) of the SN and five other core neurocognitive networks (Gordon et al, 2016): (1) the default mode network (DMN), which underlies self‐oriented thought and includes the medial prefrontal and poster cingulate cortex; (2) the ventral attention network (VAN), involved in detection of unexpected but behaviorally relevant stimuli and includes the temporoparietal junction and the ventral frontal cortex; (3) the dorsal attention network (DAN), involved in top‐down controlled attentional selection and includes the superior parietal lobe, intraparietal sulcus, and ventral premotor cortex; the (4) frontoparietal network (FPN), involved in top‐down control of executive functioning and compromised of dorsolateral prefrontal cortex and posterior parietal cortex (Sheffield et al, 2015; Vossel et al, 2014); and (5) the cingulo‐opercular network (CON), which is involved in instantiating and maintaining task performance, lies posterior and dorsal to the SN, and includes dorsal anterior insula and anterior medial superior prefrontal cortex (Dosenbach et al, 2006). We also tested for associations among PCE, SN rsFC, and symptoms of child psychopathology, given that prior studies using ABCD data have reported significant effects of PCE on child symptoms associated with psychotic‐like experiences, internalizing, externalizing, thought disorder, and problems with attention and social function (Ingstrup et al, 2018; Paul et al, 2021).…”

“…Three recently published studies leveraged the ABCD data set to examine associations between PCE and childhood outcomes. These studies linked PCE to childhood sleep disorders, psychosis proneness, and psychopathology (e.g., externalizing and internalizing problems; Ingstrup et al, 2018;Paul et al, 2021). Paul et al (2021) additionally linked PCE to lower birth weight, lower total intracranial volume, and lower white matter volumes among offspring, suggesting adverse effects on child neurodevelopment.…”

Maternal antibiotic use during pregnancy and asthma in children: population-based cohort study and sibling design

“…Antibiotics are commonly prescribed to pregnant women, with ∼40% redeeming at least one antibiotic prescription during pregnancy [1,2]. Some antibiotics can reach the fetal circulation by transferring across the placenta [3]; additionally, prenatal exposure to antibiotics may impact the child's intestinal microbiome [4], altering the balance of beneficial and pathogenic bacteria, and thus increase the child's risk of developing asthma.…”